Individual
MRS. VIVIAN MADISON MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
740 W HIGHLAND DR, GATLINBURG, TN 37738-5529
(865) 436-3573
(888) 822-5006
Mailing address
740 W HIGHLAND DR, GATLINBURG, TN 37738-5529
(865) 436-3573
(888) 822-5006
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
TN 2489
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5116
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
07/17/2006
Last updated
07/08/2007
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